Review of interactions between high-risk pediatric heart transplant recipients and marginal donors including utilization of risk score models.

Background: Donor organ acceptance practices vary among pediatric heart transplant professionals. We sought to understand what is known about the interactions between the "high-risk" recipient and the "marginal donor," and how donor risk scores can impact this discussion.

Methods: A systematic review of published literature on pediatric HTx was undertaken with the assistance of a medical librarian.

ISHLT consensus statement on donor organ acceptability and management in pediatric heart transplantation.

The number of potential pediatric heart transplant recipients continues to exceed the number of donors, and consequently the waitlist mortality remains significant. Despite this, around 40% of all donated organs are not used and are discarded. This document (62 authors from 53 institutions in 17 countries) evaluates factors responsible for discarding donor hearts and makes recommendations regarding donor heart acceptance.

Coronary arteriovenous fistula between left circumflex artery and superior vena cava.

A 52-year old man presented with exertional angina and shortness of breath and was diagnosed with double-vessel coronary artery disease with a large coronary artery fistula between the left circumflex artery and superior vena cava. He was managed with off-pump coronary artery bypass grafting with closure of the fistula.